<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cop_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cop_name" data-rule="required" class="form-control" name="row[cop_name]" type="text" value="{$row.cop_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">地址:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" data-rule="required" class="form-control" name="row[address]" type="text" value="{$row.address|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">区域:</label>
        <div class="col-xs-12 col-sm-8">
            <div class='control-relative'><input id="c-areaCode" data-rule="required" class="form-control" value="{$row.areaCode|htmlentities}" data-toggle="city-picker" name="row[areaCode]" type="text"></div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">营业执照:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-business_license" class="form-control" size="50" name="row[business_license]" type="text" value="{$row.business_license|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-business_license" class="btn btn-danger plupload" data-input-id="c-business_license" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-business_license"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-business_license" class="btn btn-primary fachoose" data-input-id="c-business_license" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-business_license"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-business_license"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">资质证书:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-certificate" class="form-control" size="50" name="row[certificate]" type="text" value="{$row.certificate|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-certificate" class="btn btn-danger plupload" data-input-id="c-certificate" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-certificate"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-certificate" class="btn btn-primary fachoose" data-input-id="c-certificate" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-certificate"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-certificate"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Stamp_path')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-stamp_path" data-rule="required" class="form-control" size="50" name="row[stamp_path]" type="text" value="{$row.stamp_path|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-stamp_path" class="btn btn-danger plupload" data-input-id="c-stamp_path" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-stamp_path"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-stamp_path" class="btn btn-primary fachoose" data-input-id="c-stamp_path" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-stamp_path"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-stamp_path"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('State')}:</label>
        <div class="col-xs-12 col-sm-8">
            <label>有效<input id="c-state" data-rule="required"  name="row[state]" type="radio" {in name="row.state" value="1"}checked{/in} value="1"></label>
            <label>禁用<input id="c-state" data-rule="required"  name="row[state]" type="radio" {in name="row.state" value="0"}checked{/in} value="0"></label>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
